Lessons learned in engaging Chinese and South Asians in mental health dialogue in B.C
Dr. Kendall Ho, MD FRCPCAssociate Professor, Emergency MedicineDirector, eHealth Strategy Office
CCMHS Conference O
ctober 6th, 2011
2
“Dizzy Gillespie”: lessons
• They're not particular about whether you're playing a flatted fifth or a ruptured 129th as long as they can dance to it.
• How do you know they like your music? If I got their toes tapping, then I know I’ve got them
Essence of
Engagement
Agenda• Describe “iCON”• Commonly queries• Insights and paths forward• Questions, Discussion
Language & the Web
Effective:EnglishChronic Disease mxTechnological literacyAccurate information
Chinese & Punjabi?UntestedLanguage barriersTechnical challengesSources of informationSocio-cultural factors
Understanding the Problem• Accurate & quality health information
• Enable self-care & health partnerships– Impact on chronic disease management– Health consumers & health professionals– Between generations & care givers– Peer to peer
• Serving multicultural public– Internet language marginalization– Computer skills– Hunger for health knowledge
InterCultural Online Health Network (iCON)
1. Provide 24/7 access to culturally relevant health information to support self management & wellness
2. Use multi-channel engagement to reach a variety of community members’ needs/ preferences
3. Unique technological opportunities to support mental wellness
Common Queries
evaluation
Diabetes events & on line 2010-11
• sample size• Over 138,000 data points
• Meaningful translations• Strong Parallel Reliability
between languages
• Variety of available avenues of analysis
415 Punjabi
256Chinese
671Surveys
Demographic Profile
Punjabi Forums: Sex and Age Chinese Forums: Sex and Age
Common Queries1. Is there interest?
11Health Forum, Vancouver
http://www.cbc.ca/video/#/News/Canada/BC/1258521056/ID=1757875862
Live Forum ComponentLanguage/Community Topic When Reach
Chinese – Vancouver Diabetes Sep 2007 ~700
Chinese – Vancouver Healthy Heart Apr 2008 ~1000
Chinese – Vancouver Dementia Oct 2008 ~700
Punjabi – Surrey Dementia Mar 2009 ~750
Chinese – Vancouver Liver Disease Nov 2010 ~1450
1. Community “health fair” – open house, familiar setting2. Community based interprofessional panel, Q&A 3. Volunteers – students and community4. Companion website links to live event in various ways
Public Engagement - Highlights
• Approx 95% of the surveys turned in first language
• Female 65% Male 35%
• Average 65 years (youth to late 90s)
Health Status
Punjabi: Diabetes Status
Chinese: Diabetes Status
Not Diabetic46%
Pre-Diabetic24%
Diabetic29%
N = 241
Not Diabetic51%
Pre-Diabetic10%
Diabetic39%
N = 410
Common Queries1. Is there interest?2. Would the Internet be useful?
Internet SkillsPunjabi: Internet Skills byEnglish Language skills
Chinese: Internet Skills byEnglish Language skills
www.iconproject.org42,958
as of 8/2011
Live Forum – “e” OutreachLanguage/Community Topic When Reach at Event
Chinese VC workshop – Van, PG, Victoria, Kelowna
Diabetes Jun 2010 ~125
Punjabi VC workshop – Van, New West, PG Diabetes Jun 2010 ~125
Punjabi live and webcast – Surrey Diabetes Nov 2010 ~900 + 294
Chinese live and webcast –Vancouver Diabetes Dec 2010 ~750 + 744
Chinese live and webcast – Richmond Mental Health Mar 2011 ~1100 + 373
Punjabi live and webcast – Abbotsford Diabetes/Mental Health
Mar 2011 ~450 + 168
Punjabi live and webcast - Kelowna Diabetes Oct 2011 ~300 + 15
1. Videoconference pilots – FoM and Health Authority VC sites2. Webcast to the whole province and beyond3. Connecting with social media
Blogging & texting
Common Queries1. Is there interest?2. Would the Internet be useful?3. Would self management apply?
Findings: Motivation to ActionWhat motivates self care?
• Desire to be an “informed patient”• Desire to learn more about prevention and
symptoms of illnesses• Recognition of limited access to time with
physicians
Findings: What does Self Care Mean?• Trying to make healthy choices but need culturally relevant
resources available in own language• Becoming better informed so they will “use the system
less”• Having sufficient knowledge to be conversant with health
professionals• Helping family members care for themselves
“The problem with doctors is that we only go for a check-up once, but our condition may change before or after, even if we are well at our appointment…and he says “ok” – we don’t know for sure….”
Necessary Ingredient: Culturally relevant resources available
in own language
Common Queries1. Is there interest?2. Would the Internet be useful?3. Would self management apply?4. Would this motivate change?
Feedback• Surveys indicated that the events stimulated
participants’ willingness for positive behavioural change
“I’ll change the way I would cook my food, change my lifestyle.”
Over 90% indicated they will attend the
next event
95% responded that the forum provided new
information they will use to help cope with stress or
worry
www.iconproject.org
Mental Health: CMHA Synergy• March 5, 2011: Aberdeen Mall, Richmond• Chinese Bounce Back program collaboration
DVD: SkitsCommon situations• Immigration,isolation• Chidren’s future/Internet• Relationships, care giving• Chronic diseases, own
healthRecognition, mx skills,
seek help
What’s the Magic?
• Flour• Butter• Milk• Eggs• Sugar• Salt• Yeast
Success in Virtual Engagement
eKnowledge
ePresence
eTrust
Stepwise Strategy: 4 yr journey…1. Create in-person forums2. Establish on line presence3. Introduce on line tools4. Add virtual interactivity
Building Partnerships
iCON: What’s Next?• New content areas….Navigating the system,
Informing the system, other?• Building on social media, social drama and other
“channels”• Mobile phone communication• Opportunity to co-create “e-Peer support”• Engaging health professional trainees
“…And what can you add to a classic? Your passionate interpretation to keep it even more contemporary.”
Lang Langin Mont Blanc Ad
eOpportunities for Mental Health• Understanding the virtual social reality• Appreciating the cultural perspectives• Identifying tactics of intervention• Plan, Do, Study, Act• Engage the audience to co-create• Create modern classics in mental wellness!
AcknowledgmentsCo-authors•Helen Novak Lauscher•Sophia Khan•Eizabeth Stacy•Nelson Shen•Janice Tian
Funding Support•BC Ministry of Health Services•Lawson Foundation•Public Health Agency of Canada•Canadian Health Services Research Foundation•Irving K Barber Learning Centre, UBC
Thank you to our partners, community sponsors, volunteers, and the eHealth Strategy Office staff team
PartnersProvincial Health Services AuthorityFraser Health AuthorityVancouver Coastal Health AuthoritySUCCESS Canadian Mental Health Association, Bounce BackHealthLink BCSafeway PharmacyOmni TelevisionAberdeen CentreFairchild TelevisionFairchild RadioCanadian Diabetes AssociationMing PaoTsing TaoDepartment of Medicine, UBC Telus CorporationUBC Learning Circle
e H e a l t h S t r a t e g y O f f i c e
Web: www.eHealth.med.ubc.caFacebook: on.fb.me/ehealthstrategyTwitter: www.twitter.com/ehealhtstrategy
